Objectives:To investigate the effect of early enteral nutrition after total gastrectomy and evaluate its feasibility. Methods:25 cases of postoprative patients of stomacch carcinoma after total gastrectomy were selected and is divided into two groups at random.12 cases (control group) had accepted parenteral nutrition after operation.13 cases(test group) had accepted enteral nutrition after 24 hours of the operation though jejunostomy.The study continued for 7 days. The energy was equal approximately between groups.The nutrition state was evaluated in two groups before and after operation,and the recovery of intestinal function and hospitalized charge were compared too. Results:The postoperative body weight and nutrition state in the test group were better than those in control group and the differnces were very significant( P

AIM:To conduct the relevance analysis of serum Dickkopf-1 (Dkk-1) and bone mineral density (BMD) in the different ages of female populations.METHODS: The women volunteers (n=100, 20~80 years old) were selected and divided into young group (20~39 years old), middle age group (40~59 years old) and elderly group (60~80 years old).The serum levels of Dkk-1 in the 3 groups of volunteers were detected by ELISA.In the middle age group, 25 people of 45~55 years old were selected and divided into postmenopausal group and premenopausal group to de-tect the serum level of Dkk-1 in the 2 groups of volunteers by ELISA.The BMD was measured by the method of dual energy X-ray absorptiometry.The differences of Dkk-1 expression levels among different ages of female populations, and the rele-vance with BMD were compared.RESULTS:With the increase in age, the serum Dkk-1 expression level increased ( P<0.05), and BMD were reduced (P<0.05).The blood level of Dkk-1 and BMD negatively correlated (P<0.05) in the 3 groups of volunteers.The serum levels of Dkk-1 and BMD had stronger negative correlation in postmenopausal women group than that in premenopausal women group.CONCLUSION:With the increase in age, the expression level of serum Dkk-1 increases and the BMD level decreases, which contribute to a risk of osteoporosis.In the same age range, the postmeno-pausal women express higher level of Dkk-1, and the decreased BMD is more obvious, which contribute to a greater risk of osteoporosis.The increased level of Dkk-1 also inhibits bone formation and promotes bone resorption.It may become a new target for preventing and treating osteoporosis.

Objective:To construct double-layered controlled release system containing SDF-1 and rhBMP-2 molecules and to study the release profile of the system in vitro.Methods:The polylactic acid/chitosan(PLA/CS)nanoparticles were prepared with “emulsification-solution evaporation method”,the preparation parameters were determined by orthogonal test design.The particle size was observed by nanoparticle size analyzer,the morphology of the nanoparticles was observed with electron microscope.Then rhBMP-2 and SDF-1 were loaded into the nanoparticles in the process of emulsification,the loading efficiency and encapsulation efficiency were calculated and in vitro release was observed.Results:The double-layer nanoparticles showed spherical geometry,smooth surface and complete separation. The average particle size of the nanoparticles was (542.33 ±14.38)nm;The drug loading and incorporation efficiency of rhBMP-2 were (82.41 ±1.05)% and (24.67 ±0.43)ng/mg,those of rhBMP-2 were (75.58 ±0.84)% and (22.63 ±0.41)ng/mg,respectively. The release time of the drug from the system sustained over at least 30 days,the release profile of both drugs showed “biphasic release”. The cumulative release rate of SDF-1 and rhBMP-2 was 72.85% and 91.01% in 30 days respectively.Conclusion:The SDF-1 and rh-BMP-2 loaded PLA/CS nanoparticles have excellent morphology,high entrapment and good sustained-release in vitro.

The traditional conotation of combination of disease and syndrome means the combination of disease differentiation in traditional Chinese medicine (TCM) diseases and TCM syndrome differentiation,which was derived from the Yellow Emperor's Inner Classic.And the Treatise on Cold Damage and Miscellaneous Diseases describes the clinical application of this theory.Under the background of integrative medicine,the modern conotation of combination of disease and syndrome means TCM syndrome differentiation and treatment based on modern medicine disease differentiation,which is commonly used in the current clinical practice.The disease and syndrome combination diagnosis mode based on syndrome,etiology,pathology and pharmacology can understand the disease from a multiple and comprehensive level,in order to realize the combination and complementation of advantages from both medicines.In addition,formula-syndrome relation means the relationship between the formula and its relevant indications.In general,indications often involve syndromes,symptoms,diseases and body constitutions.And the application of formula in the Treatise on Cold Damage and Miscellaneous Diseases is the representative of this theory.Hence,the application of associated classical formula gives example to the clinical formula-syndrome relation application in modem times.

Objective To evaluate the mid-and long-term results of chimney-endovascular aneurysm repair (Ch-EVAR) on efficacy and durability.Methods Data of abdominal aortic aneurysm (AAA) patients receiving Ch-EVAR were retrospectively collected and analyzed.Results From Jan 2011 to Dec 2016,21 patients received Ch-EVAR in our institution including 18 males and 3 females with the average age 74.0 ±6.31 years.One patient died and 20 patients were followed up for an mean period of 53.2 months.During EVAR procedures 14 patients received left renal artery chimney stents,6 patients had right renal artery chimney stents and one did bilateral renal artery chimney stents.Technical success was achieved in all patients (100％).Differences between preoperative and one-week postoperative value of serum creatinine (P =0.639) and estimated glomerular filtration rate (eGFR) (P =0.804) showed no statistical difference.The differences of maximum sac diameter between preoperiation (60.1 ± 13.1 mm) and follow-up (59.2 ± 13.5 mm) was not significant (P =0.826).Six patients died during follow-up and none was aortic events related.All chimney stents were patent.One patient developed late type Ⅱ endoleak and refused reintervention regardless of aneurysm expansion.Conclusion For short hostile neck AAA patients with considerable surgical risk Ch-EVAR may be an effective and durable alternative.

Objective: To understand the oral health status and associated factors of preschool children with disabilities in Bengbu City, so as to provide evidence for preventing dental caries in children with disabilities. Methods: From September 2021 to March 2022, a total of 405 preschool children with disabilities from two rehabilitation institutions in Bengbu were randomly selected for oral health examination, questionnaire survey and physical examination. The caries prevalence rate among disabled children was analyzed. After grouping based on childrens BMI, the correlation between body mass index (BMI) and dental caries among children was explored. Multivariate binary Logistic regression analysis was employed to investigate the factors associated with dental caries occurrence in children. Results: The prevalence of dental caries in preschool children with disabilities was 74.07%, with rates of 71.01% for boys and 77.27% for girls. There was a significant difference in caries prevalence between boys and girls aged 5（66.67%，88.24%） (χ2=7.53, P<0.05). There were significant differences in the dmft index among different BMI groups (underweight: 240, normal weight: 606, overweight:30,obese:60,H=35.66,P<0.05). BMI was negatively correlated with dmft（r=-0.50，P＜0.01）. Frequent tooth brushing (2-3 times daily), the use of fluoride toothpaste, limited intake of sugary foods (< 2 times/d) in the past six months, and exclusively breastfeeding within first six months were negatively correlated with the occurrence of dental caries in disabled children (OR=0.09，0.41，0.24, P＜0.05). Sleep forward to eat，parental education level of junior high school or lower, and parental education of vocational school or high school were positively correlated with dental caries (OR=3.18，5.95，3.99，66.95，7.75，P＜0.05). Conclusions The caries prevalence rate of disabled children in Bengbu City is high and is influenced by multiple factors. It is time to strengthen the oral health training for parents and teachers in educational institutions, pay attention to childrens oral health care, and help disabled children improve their quality of life.

During the mandate duty in primary military hospital, we conducted continuing neurological education combining with the hospitals trait and department needs. By using the concept of competency-based education, we have explored a pattern of continuing medical education suitable for primary physicians. Thematic approach was implemented for acquiring professional knowledge, formative evaluation was applied for training effect assessment, and scientific clinical thinking was emphasized for promoting the demand of lifelong learning. Under the communication and efforts of teachers and learners, we have obtained good clinical effect and positive social affection by the competency-based neurological education.

OBJECTIVETo analyze early hematopoietic response and long-term survival of very severe aplastic anemia (VSAA) patients with different absolute neutrophil counts (ANC) after frontline immnunosuppressive therapy (IST).

METHODSClinical data and outcome of 145 VSAA patients treated with rabbit antithymocyte globulin combined with cyclosporine were retrospectively analyzed. Hematopoietic responses to IST and long-term survival were statistically analyzed for VSAA patients in different ANC subgroups.

RESULTSPre-IST ANC=0.05×10(9)/L acted as the best cutoff level to predict IST response at 3, 6 months. For 145 VSAA patients, early death rate was 13.4% (11/82) vs 1.6% (1/63), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group (P<0.05). Hematopoietic response rates to IST was 22.0% vs 54.0% (P=0.000) at 3 months, 34.1% vs 63.5% (P=0.000) at 6 months; the overall five-year survival rate was only (62.5±5.4) % vs (91.4±3.7) % (P=0.000) and five-year event-free survival rate was (42.3±5.5) % vs (63.1±6.5) % (P=0.003), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group.

CONCLUSIONVSAA patients with extremely low ANC (≤0.05×10(9)/L) had high early death rate and with very low response rate to frontline IST and poor survival, so it is urgent to seek for the alternative frontline therapy that will bring faster and better outcome for these patients.

Anemia, Aplastic ; blood ; drug therapy ; Animals ; Antilymphocyte Serum ; therapeutic use ; Cyclosporine ; therapeutic use ; Disease-Free Survival ; Humans ; Immunosuppressive Agents ; therapeutic use ; Leukocyte Count ; Neutrophils ; cytology ; Rabbits ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Currently,electroencephalogram(EEG),functional near-infrared spectroscopy(fNIRS),and functional magnetic resonance imaging have been widely studied and applied to neuropsychiatric disorders.In recent years,the devices which can realize the simultaneous acquisition of EEG and fNIRS has been developed and gradually applied in the studies on neuropsychiatric disorders.The review provides an introduction of the techniques of synchronized detection and data analysis for EEG-fNIRS,summarizes the analysis methods and new findings of the recent studies of stroke,epilepsy,and other neuropsychiatric disorders using EEG-fNIRS,and also discusses the future research directions.

Objective:To conduct periodic revalidation of the 15 items and 43 terms autoverification rules of blood analysis after 1 year of application, analyze the application suitability and make the rules improved.Methods:Track the results of 528 010 blood analysis samples of our hospital from August 1, 2019 to January 31, 2020, and analyze the pass rate and interception rate of autoverification; 600 specimens in total were selected randomly for microscope examination, including 300 specimens which touched autoverification rules (1 012 items of autoverification rules) and were intercepted by autoverification and 300 specimens which untouched autoverification rules and were released by autoverification. The abnormal characteristics and unacceptable Delta check of the specimens also need to be concerned at the same time.The false negative rate and false positive rate, true negative rate, true positive rate and pass correct rate of autoverification were verified and compared with the rate of the second phase verification when the autoverification rule was established. The false negative rate, false positive rate, true negative rate and true positive rate of the Delta check rule which 54 716 specimens touched were calculated and compared with the second phase verification rate when the autoverification rule was established.The results of microscopic examination were used as the gold standard for the calculation of the rates, and P<0.05 was considered as a significant difference. The false positive and true positive of 1 012 autoverification rules were analyzed item by item.The false positive and true positive of 108 specimens which touched blast cell autoverification rule were analyzed terms by terms. The mean TAT and median TAT of 528 010 specimens and 193 750 outpatient specimens were calculated respectively, and the report percentages of 528 010 samples that TAT<30, 30-60　and>60 min were calculated respectively. Analyze and evaluate the application suitability of autoverification rules to juge whether they meet the needs of doctors and laboratory. The design process and the rules and application process of autoverification were optimized and improved.Results:The autoverification pass rate was 63.06% (332 971/528 010), the interception rate was 36.94% (195 039/528 010). The false negative rate was 1.00% (1/600), the false positive rate was 12.67% (76/600), the true negative rate was 49% (294/600), the true positive rate was 37.33% (224/600), and the correct rate was 98% (294/300). The pass rate, true negative rate, true positive rate and correct rate of the periodic reverification group were higher than the second phase verification group, the false negative rate and false positive rate were lower than that the second phase verification group. The false negative rate and true positive rate of the Delta check of periodic verification group were lower than that the second phase verification group, the false positive rate and true negative rate were higher than the second phase verification group, there were significant differences in the comparition results. The mean TAT of 528 010 specimens was25 min, and the median TAT was 22 min. The mean TAT of 193 750 outpatient specimens was 23 min, and the median TAT was 20 min. The report percentages of 528 010 samples that TAT<30 min, 30 min-60 min and>60 min were 83.30% (439 819/528 010), 8.00% (42 250/528 010) and 8.70% (45 941/528 010), respectively.Conclusion:The results of periodic revalidation of autoverification after 1 years application show that the 15 items and 43 terms autoverification rules of blood analysis could meet requirements about the accuracy and efficiency of the laboratory, and have a good suitability for application.